ABSTRACT
Purpose@#This study aimed to investigate the incidence rate, types and risk factors for delirium in patients admitted to the surgical Step-Down Unit (SDU). @*Methods@#This study was a retrospective study of the electronic medical records of patients admitted to a surgical SDU from February 2020 to July 2020. The delirium assessment was conducted using the short Confusion Assessment Method (a tool that allows quick and easy screening of delirium) and the incidence and risk factors for delirium were determined. @*Results@#Among a total of 227 patients in the study, the incidence rate of delirium was 35 cases (16.7%). It predominantly occurred on the first day (n = 16, 45.7%) and the second day of admission (n = 15, 42.8%). The peak occurrence of delirium was between 14:00 and 22:00 (n = 30, 85.7%). The most common type of delirium was hypoactive (n = 19, 54.3%). The results of multiple logistic regression analysis indicated that the factors influencing the occurrence of delirium in the surgical step down unit (SDU) were age, hypertension, stroke, white blood cell count, and the use of restraints. @*Conclusion@#Considering the characteristics of high-risk groups for delirium in the surgical SDU, it is necessary to establish nursing practice guidelines to minimize delirium.
ABSTRACT
In general the appearance of cerebrospinal fluid (CSF) is the most important sign of adequate dura puncture. We experienced an unusual case of spinal failure due to the blockage of a spinal needle hole by a foreign body. After the needle tip penetrated the dura, the stylet was removed, but we could not see a free flow of CSF. We found that a small rubber fragment of the local anesthetic bottle plug was on the spinal needle tip. The reason for this was the aspiration of the local anesthetic with an 18 gauge introductory needle.